Abstract
ObjectiveTo create a novel neurological vital sign and reliably capture MS‐related limb disability in less than 5 min.MethodsConsecutive patients meeting the 2010 MS diagnostic criteria and healthy controls were offered enrollment. Participants completed finger and foot taps wearing the MYO‐band© (accelerometer, gyroscope, and surface electromyogram sensors). Signal processing was performed to extract spatiotemporal features from raw sensor data. Intraclass correlation coefficients (ICC) assessed intertest reproducibility. Spearman correlation and multivariable regression methods compared extracted features to physician‐ and patient‐reported disability outcomes. Partial least squares regression identified the most informative extracted textural features.ResultsBaseline data for 117 participants with MS (EDSS 1.0–7.0) and 30 healthy controls were analyzed. ICCs for final selected features ranged from 0.80 to 0.87. Time‐based features distinguished cases from controls (P = 0.002). The most informative combination of extracted features from all three sensors strongly correlated with physician EDSS (finger taps rs = 0.77, P < 0.0001; foot taps rs = 0.82, P < 0.0001) and had equally strong associations with patient‐reported outcomes (WHODAS, finger taps rs = 0.82, P < 0.0001; foot taps rs = 0.82, P < 0.0001). Associations remained with multivariable modeling adjusted for age and sex.ConclusionsExtracted features from the multi‐sensor demonstrate striking correlations with gold standard outcomes. Ideal for future generalizability, the assessments take only a few minutes, can be performed by nonclinical personnel, and wearing the band is nondisruptive to routine practice. This novel paradigm holds promise as a new neurological vital sign.
Highlights
Capturing with precision the extent of MS-related disability is critical for effective clinical care and the development of new outcome metrics for rapid testing of therapeutic agents
Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association
The total duration of time taken by participants to complete 20 finger or foot taps was calculated for all limbs using the surface electromyogram (sEMG) data
Summary
Capturing with precision the extent of MS-related disability is critical for effective clinical care and the development of new outcome metrics for rapid testing of therapeutic agents. Gyroscopes have been used in MS to assess balance-related function and rarely to improve the quality of accelerometer data.[1] The recreational use of surface electromyogram (sEMG) sensors has entered the gaming and computer control industry, but use of the commercially available sensors in clinical applications has been limited. They offer the unique ability to noninvasively measure muscle electrical activity during exam tasks and provide quantitative assessments of limb movement. We determined if extracted features from the three sensors (surface electromyogram, gyroscope, and accelerometer), individually and in combination, can be reliably measured, are associated with standard and validated measures of MS disability, and to evaluate their potential to help detect subtle dysfunction in comparison to healthy controls
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